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• W9726975 abstract "Entre 1971 et 2002, 80 patients ont été opérés dans le service de chirurgie générale et endocrinienne de l’hôpital C.Huriez du CHRU de Lille pour un ou des insulinomes. L’étude porte sur 13 de ces patients qui étaient atteints de néoplasie endocrienne multiple de type 1 (NEM1) prouvée ou supposée. Cette pathologie diffère des insulinomes sporadiques car l’atteinte du pancréas est plurifocale. L’énucléation simple n’est alors plus envisageable sous peine de récidive. L’étude de la littérature propose différentes stratégies pour la localisation préopératoire des tumeurs et le choix du geste chirurgical. Cette étude est une analyse rétrospective de la stratégie chirurgicale établie par l’A.F.C.E et le G.E.N.E.M. Son but est de valider cette stratégie en y intégrant l’apport des techniques du diagnostic génotypique, en simplifiant l’imagerie pré-opératoire et en réappréciant l’apport des dosages per-opératoires. Between 1971 and 2002, 80 patients underwent surgery for insulinoma at the Department of General and Endocrine Surgery of the Lille University Hospitals. The present report deals with 13 patients with proven multiple endocrine neoplasia type I (MEN I) or supposed genetic-related insulinomas. This entity differs from spontaneous insulinoma by the presence of multiple foci in the pancreas. Enucleation is not advised in this setting due to the strong likelihood of persistence or recurrence. Various studies suggest different strategies for preoperative localization and surgical approach. We analyzed retrospectively the surgical strategy proposed by the A.F.C.E. and G.E.N.E.M. The purpose of this study was to validate the strategy, integrate the contribution of genotypic diagnosis, simplify preoperative imaging studies, and re-evaluate the value of intraoperative baseline secretin-stimulated insulin measurements. We recommend preoperative endoscopic ultrasonography of the pancreatic head only and routine left pancreatectomy with enucleation of cephalic tumors under intraoperative hormone monitoring. Preoperative invasive localization studies are proposed only if the endoscopic ultrasonography is negative for the pancreatic head. Intraoperative secretin stimulation test can be useful in difficult cases, especially with concurrent nesidioblastosis or in case of secondary surgery. All but one of the 13 patients achieved long-term cure with this strategy." @default.
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• W9726975 date "2004-04-01" @default.
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• W9726975 title "Les insulinomes de l’adulte d’origine génétique supposée. Validation de la stratégie chirurgicale de l’A.F.C.E./G.E.N.E.M." @default.
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• W9726975 doi "https://doi.org/10.1016/s0003-4266(04)95663-6" @default.
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